158 16TH ST - NEW ELECTRIC SERVICE S;' CITY OF ATLANTIC BEACH
1'°' ' 800 SEMINOLE ROAD
jV r
` -� / v ATLANTIC BEACH, FL 32233
<4O,i7> INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES18-0287
Description: NEW ELECTRIC SERVICE
Estimated Value: 4800
Issue Date: 8/29/2018
Expiration Date: 2/25/2019
PROPERTY ADDRESS:
Address: 158 16TH ST
RE Number: 171879 0000
PROPERTY OWNER:
Name: POLYTINSKY GABRIELE MARSHA KLING
Address: 158 16TH ST
ATLANTIC BEACH, FL 32233-5804
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
JACKSONVILLE BEACH, FL 32250
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
CITY OF ATLANTIC BEACH ^~
".800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 e RES(8—b Z87
JOB ADDRESS: t SI ((e."' S'' r PERMIT# PA'S r y- 00 5.-
----.____._
TEA INFORMATION REQUIRED ON ALL PERMITS SD() AMPS NV VOLTS I PHASE
VALUE OF WORK s LieuU, +
NEW VICE E Overhead 0-1.1nderground Eli Underground up Pole
,/7 esidential (Main)Service
U0-100 amps U 101-150amps X51-200amps amps # of Meters
L1 Commercial(Main) Service
L0-100 amps L 10I-150amps U 151-200amps 'n amps I..'CT Service amps
Conductor Type Size
7Multi-Family(Main)Service
.I0-100 amps l_J 101-150amps L.:;]51-200amps amps #of Unit Meters
ilTemporary Pok 1.1 amps
SERVICE UPGRADE L; amps i:! CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.)
1"100 amps I:]I 50amps 17200amps I: „amps ,..ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101.200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits:' # circuits @ kw
Number of Lighting Outlets, including Fixtures:
OTHER ELECTRICAL PROJECTS
Ti Swimming Pool USign Smoke Detectors_Qty r;Transformers KVA El Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
E.'Replace Burnt/Damaged Meter Can -i:;Safety Inspection IJ Panel Change :DOH to UG
C7 Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months, I hereby certify that I have
read this application and know the same to be true and correct, All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name felly f//1/S 4' Phone Number
Electrical Company ISM, r C-Z� 1 c- 1- Office Phone Z4 7'98c ax
Co. Address: i/C I Cpk City ( ' State fi- Zip 5121-6
License Holder(Print): 'f'-vt- feArt . . v ertification/Registration# L 't 30 IS
Notarized Signature of License holder L
�„,,,,;;‘,"15,..#„ SHERRI L STEPP Sworn and subscribed before me .•' ' d= . o /¢V7 201E
li +, o Notary Public•Stale at Florida --
i.
:• Commission# FF 994782 Signature of Notary Public 0 *A' j,
:*1 :+ 44 My Comm.Expires May 31.2020
° ,9�,„`i'” Bonded through National Notary Assn. Or
ri�J'
3\
Cash Register Receipt Receipt Number
\' y City of Atlantic Beach R6179
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $129.00
ERES18-0287 Address: 158 16TH ST APN: 171879 0000 $129.00
ELECTRICAL $125.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC NEW SINGLE FAMILY 455-0000-322-1000 200 $70.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R6179 $129.00
Date Paid: Wednesday, August 29, 2018
Paid By: KNIGHT ELECTRIC LLC
Cashier: CB
Pay Method: CREDIT CARD 081905
tolik
Printed:Wednesday,August 29, 2018 9:19 AM 1 of 1